Generali Deutschland AG is one of Germany’s largest primary insurers and part of the Italian insurance group of the same name. It includes well-known insurance brands such as Dialog, CosmosDirekt, ADVOCARD, and Generali itself.
As a change management partner for agile transformation, ThoughtWorks works with Generali employees in interdisciplinary teams on business-critical issues. ThoughtWorks provides support for sustainable change and implements various digital solutions and products together with Generali’s teams.
Automation of claims processing
Previously, Generali claims processors had to manually review for plausibility and type out invoice data for individual cases before insurance payments could be made. This represented a massive amount of work for insurance claims - often hundreds per day - so the company sought to automate these processes as much as possible.
Together with ThoughtWorks, a solution was developed that enables Generali to automate 90 percent of the processing of tens of thousands insurance claims from the first integrated service providers. The solution processes claims data automatically, orchestrating loosely coupled microservices of a previously monolithic process and containerising the applications on a managing platform.
Thoughtworks' guidance has enabled us in several dimensions. The special consulting concept focuses on moving forward and learning together, and in sum leads to innovative solutions - which carry us into the future as we strive for further automation.
The process starts when the claims processor initiates an invoice or cost estimation. If certain conditions are met, the service provider sends receipt of a positive verification. The claim is then moved forward forward for the compensation to be paid.
Previously, at this point, the claims processors had to check both the service provider's invoice and the test report itself for reimbursement eligibility, then manually transfer the key parameters to the claims system and, if necessary, initiate two payments.
In the new system, the service provider's fee invoice and test report are automatically checked for reimbursement eligibility and scope. Among other things, duplicate and false reports are also analyzed. Both the payment to the respective party (customer, claimant, service provider, workshop, etc.) and an information letter are generated automatically. If all requirements are met, the automatic process is also extended to case closure. This eliminates the need for further manual steps.
Reduced workload for teams and improved service experience through faster payments
The success can be measured above all in the reduced workload of the claims processors: they are now relieved of standard tasks and can devote themselves to the more complicated and inconsistent cases. A process that previously took several minutes per case has been reduced to a few seconds. The service providers’ invoices of claims repair as well as their fees are now allocated more immediately and reliably. As a result, the clients now get their payments faster leading to higher customer satisfaction.
Thoughtworks simply works differently than other consulting firms: True collaboration – and shared learning – are at the forefront here. The combination of technical and agile coaching is highly effective and has helped us enormously.
This initiative has additional influence on the progress of agile transformation at Generali. Working with IT and business units, ThoughtWorks established an agile culture and practices. At the same time, new technologies for continuous delivery, test automation, containerization, and AWS cloud infrastructure were introduced; leveraging Terraform for automated provisioning of AWS EC2 instances and Amazon MSK for processing streaming data. The cultural shift also leads to more transparency and less friction between areas. It also gave the team confidence and courage to explore new and innovative avenues while generating tangible business value for Generali.
The successful implementation of this initiative led to greater acceptance for further agile transformation among business units, IT services and executive management. The next step will be to drive forward the automation of additional service providers in order to generate more substantial benefits for Generali’s business development.